AMOEBAE IN URINE 12/ 



The case was treated with emetine hydrochloride hypodermically (i grain 

 daily), and on the fifth day the amoebae disappeared completely and were 

 not found again, though the case was carefully controlled for over a 

 month. An attempt to infect a kitten per anurn with amoebae from the 

 urine gave negative results, as also did a similar experiment with the 

 amoebae from the stools. 



Macfie (1916) describes one case in a European, and records four 

 others in natives, of urinary amoebiasis seen on the Gold Coast. The 

 parasites were found in the urine, but never in the stools. They were 

 generally " quiescent," but sometimes showed sluggish movements ; and 

 they were usually degenerate, owing, it is suggested, to the harmful action 

 of urine on them. Sometimes they contained red blood corpuscles. 

 They measured 7-33 fj, in diameter, but 50 individuals measured on 

 one occasion gave an average of only 10 /i. The nucleus possessed 

 " a well-defined nuclear membrane, retractile, and clearly differentiated 

 from the surrounding endoplasm. On the inner side of this membrane 

 there was usually a large amount of chromatin arranged in irregular 

 nodular masses, and throughout the nuclear substance similar chromatic 

 matter was distributed. The karyosome was large and showed a centriole." 

 It is difficult to see much resemblance to Entamoeba histolytica in this 

 account, but the author states it as his belief " that these amoebae cannot 

 be differentiated from Entamoeba histolytica (tetragena)." He also states 

 that he found cysts in the urine, ** but none was seen containing more 

 than four nuclei." These " cysts " are not figured — nor, indeed, are the 

 amoebae, (It may be recalled that the " cysts " of amoebae which Macfie 

 (1915) described previously from a monkey are clearly shown by his 

 figures to have been Blastocystis.) Dr. Macfie very kindly sent me some 

 preserved sediment from the urine of one of his cases. I have examined 

 it very carefully, but have been unable to find anything but pus and 

 various tissue-cells in it. No recognizable amoebae, and nothing even 

 resembling cysts of E. histolytica, have rewarded my search. I am 

 therefore still unconvinced that the structures which he observed were 

 really amoebae. 



Ward, Coles, and Friel (1916) discovered "amoebae" in the urine 

 of a case of jaundice, and proposed to call them "Amoeba urinae 

 graniilaia." From their account, and the later revelations of Friel 

 (1917), there can be no doubt that the bodies in question were not 

 amoebae at all. It will suffice to note that "the bodies were totally 

 unlike Endamoeba coli or Endainoeba histolytica " (Ward, Coles, and 

 Friel, 1916) ; and that " it is probably not an amoeba in the proper 

 sense of the term," but "resembles a vegetable cell, recalling the 'proto- 

 coccus' met with in stagnant water" (Friel, 1917). 



Chalmers and O'Farrell (1917) describe a case of "urinary amoeb- 

 iasis " in a Greek woman in the Sudan, and mention several others in 

 which they found amoebae " always more or less encysted, and more 

 or less degenerate." In the case described they were non-motile, 

 "roundish," and measured about 18 /m in diameter, with a nucleus of 4/^. 

 They were believed to be a "pre-cystic stage " of E. histolytica. On one 

 occasion " numerous degenerating cysts appeared in the urine." The 

 authors find " no rccjson to doubt" that their identification was correct : 

 but their description and figure (a photomicrograph) convince me that 

 they were mistaken. 1 cannot recognize E. histolytica in either ; and 

 their belief in the patient's "response" to emetine treatment seems by 



